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Caesarean Section Flashcards Preview

What is a Caesarean Section (CS)?

It is a surgical technique whereby the fetus is delivered through an incision in the uterus

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How common is caesarean section?

It is the mode of birth in 30% of births

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What is the two main reasons why caesarean sections have been rising over the last 50 years?

1. Increasing incidence of conditions which are more likely to lead to CS such as advanced maternal age and increasing maternal obesity2. More risk averse population

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What is the most common reason for women having a CS now?

PHx of CS – women who have had one CS for whatever reason, will have another.

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What is the difference between an elective and emergency CS?

An elective CS would have been planned in the antenatal period and performed before the onset of labour. An emergency CS is performed in labour or unplanned in the antenatal period.

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What anatomical location do 99% of all CS nowadays take place? Why is this incision used?

Lower Uterine Segment. Old skool practices of having a vertical incision in the upper uterine segment are 20 times more likely to rupture in the next pregnancy.

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If a woman decides to have one CS what is the risk of uterine rupture if you try to vaginally deliver for the next baby? What is the risk of perinatal death?

1/200 will have uterine rupture. 1/5 of these women will die.

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What are 4 indications for CS? (There are 9)

Uterine ScarObstructed Labour Inadequate progress in labour and/or fetal compromiseMalpresentation – transverse or oblique lie. Breech can be delivered vaginally.Antepartum Haemorrhage – related to placenta praevia and how far from the os the placenta lies.Severe pre-eclampsia and eclampsia – in extreme preterm, cervix is unripe if delivery needs to happen. So CS is necessaryMultiple Pregnancy – If there is malpresentation of the first twin then CS is indicated.Probable cephalopelvic disproportion Maternal Request – need to be well informed